A Pilot Validation Study of the Newborn Behavioral Observations System: Associations with Salivary Cortisol and Temperament.
Jayme Congdon, J. Kevin Nugent, Beth McManus, Michael Coccia, Nicole Bush (2020). A Pilot Validation Study of the Newborn Behavioral Observations System: Associations with Salivary Cortisol and Temperament. Journal of Developmental & Behavioral Pediatrics, 2020 Aug 26. doi: 10.1097/DBP.0000000000000842. Online ahead of print.
Abstract
Objective
There are few standardized neonatal neurobehavioral instruments available for longitudinal child development research. We adapted the established clinical tool, the Newborn Behavioral Observations (NBO) system, for research by standardizing the administration protocol and expanding the three-point coding scale to five points. We describe its reliability and concurrent validity.
Methods
We administered the five-point NBO to 144 racially/ethnically diverse late-preterm or full-term infants born to low-income women (average age of five weeks). Cronbach’s alphas were calculated to determine internal consistency reliability of the subscales (Autonomic, Motor, Organization of State, and Responsivity). We examined concurrent validity by assessing sub-scale associations with infant salivary cortisol reactivity to the NBO and maternal report of infant temperament.
Results
Two of the four NBO subscales, Organization of State and Responsivity, had excellent (0.91) and good (0.76) reliability, respectively, and were retained for further analyses.
Infants with higher Organization of State scores (more optimal state regulation) demonstrated lower cortisol reactivity ( r = -0.30, p < 0.01) and temperamental negativity ( r = -0.16, p < 0.05). Responsivity was unrelated to cortisol reactivity or temperament.
Conclusions
State regulation, as measured by the five-point NBO, was associated with a biologic marker of infant stress response to the NBO administration and reported temperament. Given the paucity of neurobehavioral assessment tools for infants, these findings justify further research to investigate the generalizability of its psychometrics in other samples as next steps in the incremental progression toward the development of a practical, reliable, and predictive measure of early neurobehavioral development.